SF 892

Introduction - 84th Legislature (2005 - 2006)

Posted on 12/15/2009 12:00 a.m.

A bill for an act
relating to state employees; requiring health coverage
for state employees to permit unrestricted choice of
health care provider; amending Minnesota Statutes
2004, section 43A.23, subdivision 1.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2004, section 43A.23,
subdivision 1, is amended to read:

Subdivision 1.

General.

new text begin (a) new text end The commissioner is
authorized to request bids from carriers or to negotiate with
carriers and to enter into contracts with carriers which in the
judgment of the commissioner are best qualified to underwrite
and service the benefit plans. Contracts entered into with
carriers are not subject to the requirements of sections 16C.16
to 16C.19. The commissioner may negotiate premium rates and
coverage provisions with all carriers licensed under chapters
62A, 62C, and 62D. The commissioner may also negotiate
reasonable restrictions to be applied to all carriers under
chapters 62A, 62C, and 62D. Contracts to underwrite the benefit
plans must be bid or negotiated separately from contracts to
service the benefit plans, which may be awarded only on the
basis of competitive bids. The commissioner shall consider the
cost of the plans, conversion options relating to the contracts,
service capabilities, character, financial position, and
reputation of the carriers, and any other factors which the
commissioner deems appropriate. Each benefit contract must be
for a uniform term of at least one year, but may be made
automatically renewable from term to term in the absence of
notice of termination by either party. The commissioner shall,
to the extent feasible, make hospital and medical benefits
available from at least one carrier licensed to do business
pursuant to each of chapters 62A, 62C, and 62D. The
commissioner need not provide health maintenance organization
services to an employee who resides in an area which is not
served by a licensed health maintenance organization. The
commissioner may refuse to allow a health maintenance
organization to continue as a carrier. The commissioner may
elect not to offer all three types of carriers if there are no
bids or no acceptable bids by that type of carrier or if the
offering of additional carriers would result in substantial
additional administrative costs. A carrier licensed under
chapter 62A is exempt from the taxes imposed by chapter 297I on
premiums paid to it by the state.

new text begin (b) new text end All self-insured hospital and medical service products
must comply with coverage mandates, data reporting, and consumer
protection requirements applicable to the licensed carrier
administering the product, had the product been insured,
including chapters 62J, 62M, and 62Q. Any self-insured products
that limit coverage to a network of providers or provide
different levels of coverage between network and nonnetwork
providers shall comply with section 62D.123 and geographic
access standards for health maintenance organizations adopted by
the commissioner of health in rule under chapter 62D.

new text begin (c) Whether coverage under this section is insured through
a carrier or self-insured, each plan of coverage must permit the
enrollee to receive covered health care services from the
enrollee's choice of any licensed or registered health care
provider for any primary or specialty care within that
provider's legally permitted scope of practice. The enrollee's
choice of provider must not be subject to referral requirements,
network restrictions, higher out-of-pocket costs for the
enrollee, or any other restriction on the enrollee's choice of
provider.
new text end

Sec. 2. new text begin EFFECTIVE DATE.
new text end

new text begin Section 1 is effective beginning with the 2006 benefit year.
new text end